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General NPI Number Information
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NPI Number | 1902599970
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Entity Type | Individual
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Provider Name | LEILANI REY CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/26/2023
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 8961 TESORO DR FL 4
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6209
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Country | US
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Telephone | 210-407-0185
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Fax |
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Provider Business Mailing Address
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Address Line | 3838 LOCKHILL SELMA RD APT 916
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City | SAN ANTONIO
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State | TX
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Zip | 78230-1575
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Country | US
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Telephone | 210-219-0956
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 118727
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License Number State | TX
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